Arkansas lawmakers have approved a plan to preserve the state's first-in-the-nation hybrid Medicaid expansion, backing an unusual tactic that will require a veto from Republican Gov. Asa Hutchinson to save the program covering more than 250,000 poor people.

The House on Thursday voted 76-13, with 11 lawmakers voting present, to approve a Medicaid budget bill that sets a Dec. 31 end date for the program. The budget measure needed at least 75 votes. The vote Thursday had the effect of saving the program even though the measure they voted on would end it on Dec. 31. That is because Hutchinson has promised to issue a line-item veto only on the Dec. 31 ending date. He's expected to have more than enough votes in the Legislature to uphold that decision, which would preserve the program known as Arkansas Works.

Hutchinson and legislative leaders pushed for the line-item veto plan after conservative Republicans opposed to the Medicaid expansion prevented the Senate from voting by the required three-fourths majority to fund it.

A handful of Republican opponents of the expansion backed the revised budget on Thursday.

"The beauty of this bill we have in front of us today is those of us who voted no and are opposed to Arkansas Works, we have accomplished what we asked for," said Republican Rep. Laurie Rushing, referring to the hybrid expansion. "We asked that Arkansas Works be removed from the appropriation and it has."

Democrats also supported the maneuver, despite concerns that it required them to initially vote to end a program they've fought to save.

Arkansas was the first state to win approval for its hybrid approach, created three years ago as an alternative to expanding Medicaid under President Barack Obama's federal health care law. More than 250,000 people are covered by the program, which health advocates have credited for a dramatic drop in the number of uninsured people in the state. The hybrid expansion sharply divided Republicans who control both chambers of the Legislature.

Hutchinson repeatedly derided the federal health overhaul when he ran for governor two years ago, but did not say what he would do about the Arkansas program that was already covering thousands of people. Lawmakers earlier this month approved his plan to add new restrictions to the program, including a requirement that some participants pay premiums.

Opponents of the Arkansas program have called the line-item veto maneuver an end-run around the state's budget process and predict it'll be challenged in court. Hutchinson and legislative leaders have said they believe the line-item veto would withstand a legal challenge. The budget bill includes a provision to ensure that other parts of the Medicaid budget aren't jeopardized if a court rules otherwise.

The tactic even drew objections from a member of the governor's family who is a supporter of the expansion but voted against Thursday's budget bill.

"We're doing the right thing in the wrong way and it's setting a precedent for your kids and my kids and my grandkids that we should not be doing," said the governor's brother-in-law, Republican Rep. Kim Hendren, who said he was prepared to vote for the maneuver if he needed to be the 75th vote.